Comparative analysis of the clinical value of two-dimensional and three-dimensional contrast-enhanced ultrasonography in the diagnosis of uterine submucosal myoma / 中国基层医药

ABSTRACT

Objective To compare the clinical value of uterine submucosal myoma classification by two dimensional and three-dimensional contrast-enhanced ultrasonography and surgical pathologic results.Methods The imaging data of ultrasonographic hysterography including 2D and 3D of 124 patients with uterine submucosal myoma were retrospectively analyzed,and the results were compared with the surgical pathologic results.The diagnostic accuracy of uterine submucosal myoma classification and the operation success rate of uterine submucosal myoma for Ⅰ grade by ultrasonographic hysterography including 2D and 3D were compared.Results The patients were diagnosed pathologically with 0,Ⅰ and Ⅱ grade of uterine submucosal myoma in 26 cases,52 cases,68 cases,respectively.The patients were diagnosed by 2D ultrasonic sonohysterography with 0 grade,Ⅰ grade and Ⅱ grade of uterine submucosal myoma in 26 cases,62 cases,58 cases,respectively.The patients were diagnosed by 3D ultrasonic sonohysterography with 0,Ⅰ and Ⅱ grade of uterine submucous myoma in 26 cases,52 cases,68 cases,respectively.For pathological results as thegold standard,the diagnostic sensitivity,specificity and accuracy of uterine submucosal myoma for 0 grade by 2D and 3D ultrasonic sonohysterography were all 100.00％.The diagnostic sensitivity,specificity and accuracy of uterine submucosal myoma for Ⅰ and Ⅱ grade by 2D ultrasonic sonohysterography were 92.32％,79.46％,85.00％,respectively.The diagnostic sensitivity,specificity and accuracy of uterine submucosal myoma for Ⅰ and Ⅱ grade by 3D ultrasonic sonohysterography were 96.24％,88.24％,91.76％,respectively.There were significant differences in the diagnostic sensitivity,specificity and accuracy of submucosal myoma of uterus for Ⅰ and Ⅱ grade by 2 D and 3 D ultrasonic sonohysterography (x2 =3.21,2.78,2.17,2.33,all P ＜ 0.05).The patients diagnosed as uterine submucous myoma for 0 grade all underwent the hysteroscopic surgery for successful resection,while the patients with uterine submucous myoma for Ⅱ grade underwent laparoscopic surgery or open surgery.The operation success rates of uterine submucous myoma for Ⅰ grade by hysteroscopic surgery diagnosed by 2D and 3D ultrasonic sonohysterography were 75.81％,98.07％,respectively.The operation success rate of uterine submucous myoma for Ⅰ grade by hysteroscopic surgery diagnosed by 3D ultrasonic sonohysterography was significantly higher than that diagnosed by 2D ultrasonic sonohysterography (x2 =7.15,P ＜ 0.05).Conclusion The accuracy of uterine submucosal myoma classification by 3D ultrasonographic hysterography is better than 2D ultrasonographic hysterography.